Drugs trouble

 Shortage of essential medicines and supplies in public hospitals is not new but the situation has reached a tipping point, stretching even to private health facilities.

The Pharmaceutical Society of Malawi (Phasom) monitored the supply chain and other pharmacy-related trends and found that the supply fill ratio is as low as 35 percent.

Phasom president William Mpute told Weekend Nation that they engaged pharmacy managers and suppliers who revealed that stock-outs of essential drugs have worsened in both public and private facilities.

Ideally, he said, they expect 80-90 percent supply fill rate of essential commodities, but currently the ratio is below 50.

The development means scores of patients requiring essential medicines are either not getting treated in time or are being forced to jump from one facility to another in search of prescribed medication.

“The actual depressing revelation is that some public facilities are experiencing prolonged stock-outs of more than three months… Sometimes we have been in a situation where the whole Malawi does not have certain essential medicines or life-saving drugs,” bemoaned Mpute.

He said their engagement with local drugs and medical suppliers revealed that if the prevailing forex shortage remains unaddressed the country risks a full-blown health crisis.

Since last year, pharmaceuticals have been struggling to import medicines and other medical supplies due to the shortage of US dollars, a preferred currency for procurement on the international market.

Phasom has since proposed a crisis meeting with key stakeholders in the supply chain of medicines, including the Ministry of Health’s Health Technical Support Services (HTSS) Department, local manufacturers and suppliers, Pharmacy and Medicines Regulatory Authority (PMRA), Central Medical Stores Trust and RBM.

“We already communicated with them and we hope it will be adopted by all parties… This is a matter of urgency and should be treated as such by everyone involved. We have sang the stock-out song for so long, it’s time we found lasting solutions through collective efforts,” said Mpute.

He recalled that such challenges had previously been experienced but solutions were found after consultations with key stakeholders, notably the recapitalisation of CMST and allocation of 10 percent to district hospitals for emergency procurement.

Queen Elizabeth Central Hospital (QECH) and Zomba Central Hospital (ZCH) confirmed that the issue of shortage of essential drugs and medical supplies was no longer a secret.

ZCH director Dr Saulos Nyirenda said in a telephone interview following CMST failure to supply the ordered drugs and other supplies that they are compelled to procure from private entities.

“So our stocks are above 35 percent now. But when we order from CMST we are given around 35 percent so we top up by buying from private suppliers,” he explained.

On his part, QECH director Dr Kelvin Mponda said, without directly referring to Phasom findings, “until now we are still struggling.”

He stated that the country’s main referral hospital, gets less than 50 percent of essential items ordered from CMST.

“But if we talk about every stuff that we need as a central hospital, CMST just gives us about 40 percent of our requirements,” Mponda said.

For two weeks, there has been no response on the matter from the Ministry of Health.

Minister Khumbize Kandodo Chiponda referred Weekend Nation to HTSS director Godfrey Kadewere who promed to respond but did not by press time. But the minister conceded  early this month that stocks of essential drugs in the country have reached low levels and described the development as worrisome as it is crippling healthcare services.

Chiponda acknowledged the dire situation in Lilongwe when she received a 165-tonne consignment of medical drugs and anti-cancer medicine from the Government of India.

“The drug situation is affecting our aspirations of attaining universal health coverage. As a country, we cannot currently go alone to deliver health effectively,” she said.

In an interview, Health rights advocate Grace Febbie Ngulube feared that the drug situation will have significant implications on the healthcare system as well as the population at large.

She attributed the low supply fill rate of essential drugs to inefficiency in the distribution and procurement of essential medicines and supplies.

Parliamentary Committee on Health chairperson Mathews Ngwale expressed concern with the situation, which he observed was exacerbated by the unavailability of forex